Effect of Posterior Capsule Tightness and Humeral Retroversion on 5 Glenohumeral Joint Range of Motion Measurements: A Cadaveric Study

2019 ◽  
Vol 47 (6) ◽  
pp. 1434-1440 ◽  
Author(s):  
Dayana P. Rosa ◽  
Paula R. Camargo ◽  
John D. Borstad
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Posterior Capsule ◽  
Joint Range Of Motion ◽  
Motion Measurements ◽  
Humeral Retroversion ◽  
Clinical Measurements ◽  
Joint Range

Background: Altered glenohumeral joint range of motion can be caused by increased humeral retroversion (HR) and/or posterior capsule tightness (PCT). To make informed clinical decisions, it is vital to understand how HR and PCT alterations, individually and in combination, affect joint range of motion measurements. Purpose: To evaluate the effect of experimental tissue alterations on clinical range of motion measures. Study Design: Controlled laboratory study. Methods: Five clinical measurements were quantified in 8 fresh-frozen cadavers under 4 experimentally created conditions: baseline (no alterations), HR condition (20° increase in HR by transecting the bone), PCT condition (20% decrease in length via thermal energy), and PCT + HR combined. Clinical measurements included bicipital forearm angle, low flexion, glenohumeral internal and external rotation, and horizontal adduction. All measurements were taken by the same blinded tester. Separate 1-factor repeated measures analyses of variance were used to evaluate the effect of the alterations on each clinical measurement. Results: There was a significant main effect of condition for bicipital forearm angle ( P = .02, F = 4.03), low flexion ( P = .02, F = 3.86), internal rotation ( P = .03, F = 3.65), and external rotation ( P < .001, F = 15.15) but not for horizontal adduction ( P = .29, F = 1.33). The HR condition resulted in a decreased bicipital forearm angle of 16.1° and 15.8° as compared with the PCT and PCT + HR conditions, respectively. When compared with baseline, the PCT + HR condition decreased the low flexion test by 13.5°, and the HR condition decreased internal rotation range of motion by 14.2°. All conditions increased external rotation when compared with baseline. Conclusion: Greater measurement changes were noted in both HR conditions, suggesting that bony alterations influence motion to a greater extent than posterior capsule alterations. Clinical Relevance: Clinicians should be aware that humeral retroversion will influence the measurement of posterior shoulder tightness.

scholarly journals Posterior Glenohumeral Joint Capsule Contracture

2012 ◽  
Vol 4 (4) ◽  
pp. 230-236 ◽  
Author(s):  
Amitabh Dashottar ◽  
John Borstad
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
Tensile Force ◽  
Joint Capsule ◽  
Posterior Capsule ◽  
Joint Mechanics ◽  
Cellular Processes ◽  
Standard Techniques

Glenohumeral joint posterior capsule contracture may cause shoulder pain by altering normal joint mechanics. Contracture is commonly noted in throwing athletes but can also be present in nonthrowers. The cause of contracture in throwing athletes is assumed to be a response to the high amount of repetitive tensile force placed on the tissue, whereas the mechanism of contracture in nonthrowers is unknown. It is likely that mechanical and cellular processes interact to increase the stiffness and decrease the compliance of the capsule, although the exact processes that cause a contracture have not been confirmed. Cadaver models have been used to study the effect of posterior capsule contracture on joint mechanics and demonstrate alterations in range of motion and in humeral head kinematics. Imaging has been used to assess posterior capsule contracture, although standard techniques and quantification methods are lacking. Clinically, contracture manifests as a reduction in glenohumeral internal rotation and/or cross body adduction range of motion. Stretching and manual techniques are used to improve range of motion and often decrease symptoms in painful shoulders.

Radioulnar Range of Motion Normative Values for Elite Baseball Players

2013 ◽  
Vol 18 (6) ◽  
pp. 32-35
Author(s):  
Kevin Laudner ◽  
Robert Lynall ◽  
Jeffrey Williams ◽  
Regan Wong ◽  
Takashi Onuki ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Outcome Measures ◽  
Glenohumeral Joint ◽  
Normative Values ◽  
Related Factors ◽  
Baseball Players ◽  
Joint Range Of Motion ◽  
Collegiate Baseball ◽  
Baseball Pitchers ◽  
Joint Range

Context:Numerous studies have documented reduced glenohumeral joint range of motion (ROM) of the dominant extremity among baseball players, which may be caused by throwing-related factors that also affect the radioulnar joint.Objective:To measure pronation and supination ROM in competitive baseball pitchers and position players.Participants:Asymptomatic professional and collegiate baseball pitchers (N = 59) and position players (N = 43).Outcome Measures:Bilateral radioulnar pronation and supination ROM.Results:Pitchers demonstrated significantly less pronation and total ROM in the throwing arm than the nondominant arm. The position players demonstrated significantly less total ROM in the throwing arm than the nondominant arm.Conclusions:The reported normative values may provide useful standards for interpretation of radioulnar ROM measured in both asymptomatic and symptomatic baseball players.

scholarly journals Physiotherapy Management of Post-Operative Breast Cancer Patients: A Qualitative Study

2014 ◽  
Author(s):  
Dragana Cepmja ◽  
Katherine Maka
Keyword(s):  
Breast Cancer ◽  
Range Of Motion ◽  
Cancer Patients ◽  
Glenohumeral Joint ◽  
Breast Cancer Patients ◽  
Treatment Interventions ◽  
Joint Range Of Motion ◽  
Frequency Of Use ◽  
Joint Range ◽  
Sydney Australia

Purpose: Post-operative breast cancer patients receive physiotherapy to improve range of motion, reduce pain, and increase strength. The aim of this study was to provide qualitative information about which techniques are utilised by physiotherapists in the management of post-operative breast cancer patients in a hospital physiotherapy outpatient department setting in Western Sydney, Australia. Method: Common interventions were listed on a survey and physiotherapists were asked to select which treatment interventions they used and the frequency of use. Results: A total of 20 surveys were completed out of 25 disseminated. The most commonly used intervention was stretches with 100% of respondents using stretches frequently. This was followed by range of motion exercises with 95% using this intervention frequently. General arm care advice and postural education were frequently utilised by 80% of respondents. Conclusions: The most common physiotherapy interventions used in the management of post-operative breast cancer patients were shoulder stretches, glenohumeral joint range of motion exercises, general arm care advice, and postural education.

The Influence of Glenohumeral Joint Posterior Capsule Tightness and Impingement Symptoms on Shoulder Impairments and Kinematics

2019 ◽  
Vol 99 (7) ◽  
pp. 870-881 ◽  
Author(s):  
Dayana P Rosa ◽  
John D Borstad ◽  
Julia K Ferreira ◽  
Paula R Camargo
Keyword(s):  
Internal Rotation ◽  
Shoulder Pain ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Posterior Capsule ◽  
Control Group ◽  
Pain Thresholds ◽  
Lower Pain ◽  
And Function ◽  
Rotation Strength

AbstractBackgroundPosterior capsule tightness (PCT) and shoulder impingement syndrome (SIS) symptoms are both associated with altered shoulder biomechanics and impairments. However, their combined effect on kinematics, pain, range of motion (ROM), strength, and function remain unknown.ObjectiveThe purpose of this study was to determine if the combination of PCT and SIS affects scapular and humeral kinematics, glenohumeral joint ROM, glenohumeral joint external rotation strength, pain, and function differently than does either factor (PCT or SIS) alone.DesignThe design was a cross-sectional group comparison.MethodsParticipants were placed into 1 of 4 groups based on the presence or absence of SIS and PCT: control group (n = 28), PCT group (n = 27), SIS group (n = 25), and SIS + PCT group (n = 25). Scapular kinematics and humeral translations were quantified with an electromagnetic motion capture system. Shoulder internal rotation and external rotation ROM, external rotation strength, and pain and Shoulder Pain and Disabilities Index scores were compared between groups with ANOVA.ResultsThe SIS group had greater scapular internal rotation (mean difference = 5.13°; 95% confidence interval [CI] = 1.53°–8.9°) and less humeral anterior translation (1.71 mm; 95% CI = 0.53–2.9 mm) than the other groups. Groups without PCT had greater internal rotation ROM (16.05°; 95% CI = 5.09°–28.28°). The SIS + PCT group had lower pain thresholds at the levator scapulae muscle (108.02 kPa; 95% CI = 30.15–185.88 kPa) and the highest Shoulder Pain and Disabilities Index score (∼ 44.52; 95% CI = 33.41–55.63).LimitationsThese results may be limited to individuals with impingement symptoms and cannot be generalized to other shoulder conditions.ConclusionsDecreased ROM and lower pain thresholds were found in individuals with both impingement symptoms and PCT. However, the combination of factors did not influence scapular and humeral kinematics.

Rotational Motion Changes in the Glenohumeral Joint of the Adolescent/Little League Baseball Player

2005 ◽  
Vol 33 (5) ◽  
pp. 693-698 ◽  
Author(s):  
Keith Meister ◽  
Timothy Day ◽  
Marybeth Horodyski ◽  
Thomas W. Kaminski ◽  
Michael P. Wasik ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Rotational Motion ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Age Groups ◽  
Baseball Player ◽  
Cross Sectional ◽  
Little League ◽  
Total Range

Background Differences in range of motion and rotational motion between the dominant and nondominant shoulders in throwing athletes are well documented, although the age at which these changes begin to occur is not known. Hypothesis Changes in glenohumeral rotational motion in the shoulder of the Little League/adolescent baseball player occur during the most formative years of physical development. Study Design Cross-sectional study. Methods Elevation, internal rotation at 90° of abduction, and external rotation at 90° of abduction were measured in the dominant and nondominant shoulders of 294 baseball players, aged 8 to 16 years. Results Analysis of variance revealed 2-way interactions between arm dominance by age for elevation (P =. 005) and internal rotation (P =. 001). Significant differences were noted between dominant and nondominant arms for internal rotation at 90° (P =.001) and external rotation at 90° (P =. 001). Elevation, internal rotation at 90°, external rotation at 90°, and total range of motion varied significantly (P =. 001) among age groups. Elevation in the dominant arms of 16-year-olds was on average 5.3° less than in 8-year-olds (179.6° vs 174.3°). In the nondominant arms, mean elevation for 16-year-olds was 5.6° less than in 8-year-olds (179.7° vs 174.1°). Internal rotation at 90° for the dominant arms averaged 39.0° at age 8 and only 21.3° at age 16. In the non-dominant arms, internal rotation for 8-year-olds averaged 42.2° and only 33.1° for 16-year-olds. Conclusions Elevation and total range of motion decreased as age increased. These changes may be consequences of both bone and soft tissue adaptation. The most dramatic decline in total range of motion was seen between the 13-year-olds and 14-year-olds, in the year before peak incidence of Little Leaguer's shoulder. This decrease in rotational motion may cause increased stress at the physis during throwing.

scholarly journals Adaptations of the Shoulder to Overhead Throwing in Youth Athletes

2015 ◽  
Vol 50 (7) ◽  
pp. 726-732 ◽  
Author(s):  
Matthew Michael Astolfi ◽  
Aaron H. Struminger ◽  
Todd D. Royer ◽  
Thomas W. Kaminski ◽  
Charles B. Swanik,
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Mixed Model ◽  
External Rotation ◽  
Posterior Capsule ◽  
Shoulder Injuries ◽  
Cross Sectional ◽  
Youth Baseball ◽  
Capsule Thickness ◽  
Overhead Throwing

Context The high number of repetitions and high forces associated with overhead throwing lead to anatomical adaptations, such as humeral retrotorsion and posterior-capsule thickness, in elite and professional baseball athletes. However, little is known about the origin and progression of these changes that may account for the increasing trend of chronic shoulder injuries in youth baseball and precipitate subsequent pathologic conditions throughout a young athlete's lifetime. Objective To investigate the relationship of age and upper extremity dominance on humeral retrotorsion, posterior-capsule thickness, and glenohumeral range of motion. Design Cross-sectional study. Setting Research laboratory, local baseball fields, and training facilities. Patients or Other Participants Thirty-six boys (mean age = 10.94 ± 1.34 years, height = 151.31 ± 12.17 cm, mass = 42.51 ± 10.32 kg) ranging in age from 8 to 12 years and involved in organized youth baseball. Main Outcome Measure(s) Diagnostic ultrasound was used to determine humeral retrotorsion and posterior-capsule thickness. Glenohumeral internal rotation and external rotation were measured using a handheld inclinometer. We used 2 × 2 mixed-model analyses of variance to compare the influence of limb dominance and age on the dependent variables of humeral retrotorsion, posterior-capsule thickness, internal rotation, and external rotation. Results The dominant shoulders of youth throwers exhibited less glenohumeral internal rotation but greater humeral retrotorsion, posterior-capsule thickness, and glenohumeral external rotation than the nondominant shoulders. Dominant internal rotation was greater in the 8- to 10-year-old group than in the 11- to 12-year-old group, and results trended toward a difference (F1,33 = 4.12, P = .05). Correlations existed between humeral retrotorsion and range of motion (P &lt; .05). Conclusions The structural adaptations in the dominant shoulders of younger baseball players were similar to adaptations observed in older baseball athletes, indicating that more examination is needed in younger athletes. We are the first to demonstrate greater posterior-capsule thickness in the dominant shoulders of youth baseball athletes.

Humeral Retroversion and Its Relationship to Glenohumeral Rotation in the Shoulder of College Baseball Players

2002 ◽  
Vol 30 (3) ◽  
pp. 354-360 ◽  
Author(s):  
K.M. Reagan ◽  
Keith Meister ◽  
Mary Beth Horodyski ◽  
Dave W. Werner ◽  
Cathy Carruthers ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Soft Tissues ◽  
External Rotation ◽  
Baseball Players ◽  
Bony Anatomy ◽  
Humeral Retroversion ◽  
College Baseball ◽  
The Difference ◽  
Mean Differences

Background Previous studies have documented changes in musculature, bony anatomy, and glenohumeral rotation in the dominant shoulder of baseball players. Hypothesis In a group of asymptomatic college baseball players the total range of motion in the dominant and nondominant shoulders will be similar. Any measured increase in external rotation and decrease in internal rotation occurring between the two sides will be consistent and directly correlate with an increased angle of humeral retroversion in the dominant extremity. Study Design Descriptive anatomic study. Methods Fifty-four asymptomatic college baseball players were examined. Standard measurements of glenohumeral range of motion were made and humeral retroversion was determined radiologically. Results Total rotational motion, measured at 90° of glenohumeral abduction, was 159.5° for the dominant shoulders and 157.8° for the nondominant shoulders. Mean differences in external and internal rotation in the dominant versus nondominant extremities were 9.7° and 8.2°, respectively. Humeral retroversion measured 36.6° ± 9.8° in the dominant and 26° ± 9.4° in the nondominant extremity. The mean difference in retroversion correlated significantly by Pearson's product moment with the difference in external (P = 0.001) and internal (P = 0.003) rotation measurements. Conclusions There is a pattern of increased external rotation and decreased internal rotation in the dominant extremity that significantly correlates with an increase in humeral retroversion. The loss of internal rotation and gains in external rotation may be more strongly related to adaptive changes in proximal humeral anatomy than to changes in the soft tissues.

Sign in / Sign up

Export Citation Format

Share Document